Glaucoma is among the leading causes of blindness in the United States and worldwide. It is estimated that more than 2.5 million people in the United States have glaucoma and that more than 130,000 people are legally blind from the disease (Gordon M O, et al., Arch Opthalmol; 120(6):714-720 (2002)). By the year 2010, the estimated worldwide prevalence of glaucoma will be 60 million, with 4.5 million being legally blind (Quigley H A, et al., Br J Opthalmol.; 90(3):262-267 (2006)). Glaucoma is commonly associated with the presence of high intraocular pressure (IOP), optic nerve damage and patterned visual field loss, but many other risk factors for glaucomatous optic neuropathy have been identified (Gordon M O, et al., Arch Opthalmol; 120(6):714-720 (2002)). In a recent review of the Ocular Hypertension Treatment Study, the most significant risk factors for the development of glaucoma included age, IOP, cup/disc ratio and thin central corneal thickness, where the latter remained an important predictor in both univariate and multivariate analyses (Gordon M O, et al., Arch Opthalmol; 120(6):714-720 (2002)). This latter finding has generated increased interest in the biomechanical properties of the ocular coat and its role in the pathophysiology of glaucoma.
In studies such as the Ocular Hypertension Treatment Study and the European Glaucoma Prevention Study, evidence suggests that a history of diabetes mellitus is inversely associated with glaucoma risk (Gordon M O, et al., Arch Opthalmol; 120(6):714-720 (2002); Miglior S, et al., Opthalmology; 112(9):366-375 (2005)) and may therefore be protective. Hyperglycemia is associated with a naturally occurring form of collagen crosslinking resulting from non-enzymatic glycation of proteins that leads to tissue stiffening (Thorpe S R, et al., Drugs & Aging; 9(2):69-77 (1996)). Computational simulations have suggested that mechanical strain in prelaminar optic nerve tissue, a potential mechanism of injury in glaucomatous optic neuropathy, is greatest as a function of IOP when peripapillary scleral stiffness is lowest (Sigal I A, et al., Invest Opthalmol Vis Sci.; 46(11):4189-4199 (2005)).
Improved therapies and preventive interventions for glaucoma are needed.